e-form

Accident Notification Form

Form should reach OHSA (email: ohsa@gov.mt) within seven (7) days after the accident in terms of LN 52/1986 Article 22.2(b)

Employer's Name





ID Card No.





Company Name





Company Registration No.
(MFSA Reg. No.)





Postal Address





Type of Industry





Email





Telephone





Date of Accident





No. of Persons involved





Place /
Address of Accident





Days out of Work (working days)





Person filing the Accident Notification

Name and Surname





Position within the Company





Signature







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